health insurance pt 2

COMPLETE CORRECT ANSWERS FOR QUESTIONS 11-2011. ÿÿPeople who receive MedicareA.ÿare never eligible to receive Medicaid.B.ÿmay be eligible to receive Medicaid if they meet the age requirement.C.ÿmay be eligible to receive Medicaid coverage.D.ÿcan combine Medicare with TRICARE.12. ÿÿRalph is assigning diagnosis and procedure codes for a 35-year-old patient from New Mexico, who has hypertension and end-stage renal disease. Would this patient qualify for Medicare?A.ÿYes, because the patient has end-stage renal diseaseB.ÿNo, because the patient resides in New MexicoC.ÿNo, because the patient is under age 65D.ÿYes, because the patient has hypertension13. ÿÿTheÿfirstÿprepaid health insurance plans in the United States wereA.ÿTRICARE and workers’ compensation.B.ÿCHAMPUS and CHAMPVA.C.ÿBlue Cross and Blue Shield.D.ÿMedicare and Medicaid.14. ÿÿWhich of the following is the largest privately underwritten health insurance contract in the world?A.ÿHarless programB.ÿSCHIPC.ÿFederal Employee Program (FEP)D.ÿCHAMPVA program15. ÿÿA provider is classified as a/anA.ÿbiller who submits claims to insurance carriers.B.ÿcoder who provides medical record data.C.ÿindividual or group of individuals that provide a health care service.D.ÿbeneficiary that provides information for insurance coverage.16. ÿÿTom is billing an emergency room visit for a Medicaid patient who’s being seen for a wellness visit. Which one of the following statements isÿtrueÿas a result of the Balanced Budget Act?A.ÿThere are new surgical treatments available.B.ÿNo new applications are required for TAFT recipients.C.ÿPatients have expanded preventive-care benefits.D.ÿThere are new standards for TRICARE.17. ÿÿDr. Singer is working within a reimbursement system in which the insurance is billed after all the treatment has been given to the patients. What is theÿmainÿreason that the doctor orders more tests, exams, and procedures under this system?A.ÿFear of being suedB.ÿTo increase resource utilizationC.ÿTo make a profitD.ÿBecause no one has to pay for it18. ÿÿWith a PPO, the beneficiary has the ability toA.ÿchoose a hospital within a 50-mile radius only.B.ÿchoose a physician or hospital from the designated provider list.C.ÿselect a dentist within a 10-mile radius.D.ÿselect an add-on policy for supplemental unemployment benefits19. ÿÿPhysician-hospital organizations (PHOs) are also called _______ organizations.A.ÿmedical staff-hospitalB.ÿhealth managementC.ÿindividual providerD.ÿpreferred provider20. ÿÿMrs. Fang is a 72-year-old retired school teacher who has been hospitalized for pneumonia. What type of insurance isÿmostÿlikely being used to pay for her hospital stay?A.ÿMedicare Part DB.ÿMedicare Part BC.ÿMedicare Part AD.ÿMedicare Part C

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